Sexual Abuse Assessment & Treatment Program

This program offers comprehensive assessment and specialized intervention and treatment as follows:

For children and youth up to age 18 who have been sexually victimized: sexual victimization may have been perpetrated by family members, people known or unknown to the family.

For children under age 12 who have sexually victimized other children: these children are engaged in behaviours that fall outside of what would normally be expected or appropriate at that age and stage of development, e.g., language or games with adult sexual themes, adult sexual behaviours directed towards other children. Many of these sexual behaviours, if engaged in by a youth over the age of 12, would be chargeable offenses. We provide comprehensive assessments in an attempt to determine the cause of the behaviours, identify the resulting disruptions in sexual development, and provide recommendations for treatment and intervention. Treatment is also provided.

For children and youth up to age 18 who have engaged in intrafamilial sexual abuse: children and youth within the same family, e.g., siblings, step-siblings, cousins; because the entire family is affected when this occurs the assessment is more complex and includes not only the children involved in the sexual behaviours but other family members as well

Comprehensive Assessment

For the duration of the assessment, the children need to be in a safe and stable living environment. Separate assessments are conducted on each child with specific recommendations for treatment. Family involvement and safety planning is an integral part of the process.

An accurate and comprehensive assessment is the cornerstone of the treatment process. Without it, interventions can be misguided and ultimately ineffective. (Source: Child Physical and Sexual Abuse: Guidelines for Treatment. 2003)

Every child and youth, and their non-offending parent/caregiver who come to us for service engage in a comprehensive assessment process, followed by treatment planning. Recommendations for intervention and/or treatment flow from that assessment.

The assessment takes a holistic perspective in which all aspects of the child's functioning are viewed. This is to better assesss the impact of the tauma/ abuse as well as identify a child or youth's strength and resiliency factors. The assessment is a process of gathering information in different ways from different sources. The child participates in up to three interviews which may involve answering questions, drawing pictures, and completing questionnaires.

Assessment of the child and his/her experiences is done in the context of their family, thus involving and seeking the perceptions of the parents/caregivers and assessing the nature of the parent-child relationship is a very important part of the process. Parents/caregivers are asked to participate in interviews and complete questionnaires. In addition to understanding the child's early life, the parents/caregivers are asked to provide their perception of the child's current functioning in many areas of the child's life (family, school, social, emotional, and the trauma they experienced).

In some cases, we may ask for other family members to be involved in the assessment process to help us better understand the child and the impact of the trauma. Often it is necessary to get official documentation about the trauma from other professionals who have had involvement with the family. These may include child welfare agencies, police, and doctors. No information is obtained without the parent and/or youth's written permission.

Assessment in the area of child sexual victimization is complex and demands a specialized approach. There is no "off the shelf" program that can meet the unique needs of these young victims and their families. However, we do know what makes for effective assessment programs with these children and youth and those particular known components – best practices - from the basis of the SAAT program at THRIVE Child and Youth Trauma Services.

Components involved in the Assessment include:

Intake which usually involves a telephone contact and/or one in-person meeting

Clinical interviews with one of our trained specialists

Psychometric evaluation of the child/youth and parents/caregivers using standardized measures

Review of relevant documents/reports and/or liaison with other involved professionals – current and past - if appropriate/required

Preparation of a summary report complete with recommendations

Feedback session between the trained specialist and family (and/or child depending on age of consent) to review the assessment report and discuss recommendations including treatment plans

Intervention/Treatment

Not every child needs extensive counseling as a result of their victimization experiences. The impact of the trauma on the child is influenced by a number of factors (age, frequency, duration, level of intrusiveness, disclosure response, emotional, psychological and cognitive functioning, and family/life circumstances). Therefore, the length of treatment is determined on a case by case basis depending on the unique needs of the child/youth.

Recommendations for treatment come from the assessment report. Treatment planning is individualized to each child/youth.

The primary treatment model used in the SAAT program is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Other approaches may also be used and may include psychodynamic, psycho-educational, experiential, family systems, play therapy, solution-focused, and specific trauma focused interventions.

Counselling is different from the assessment process. In counseling, a child/youth is supported and engaged in different ways to help them understand themselves, their strengths and struggles, the impact of the abuse, and changes they would like to make. Like other forms of counseling, trauma specific treatment can help the child express their feelings openly, and learn new ways to solve problems. Every effort is made to tailor the type of counselling to the needs of the child/youth. Not everyone requires or receives the same type of counselling.

The primary type of counselling provided is individual between the child/youth and a clinician. However, as with the Assessment, family support and involvement is very helpful for the child/youth. We value a family's input and we recognize that many of the important changes that take place for a child/youth occur at home. It is especially important to involve the caregivers in the treatment of younger children, as they are the primary change agents and ensure what is learned in counseling can be implemented and practiced at home. Therefore, family members may be involved in some or parts of the counseling sessions.

Three Phase Treatment Approach

Like the Assessment, treatment planning in the area of child sexual victimization is complex and demands a specialized approach. There is no "off the shelf" program that can meet the unique needs of these young victims and their families. However, we do know what elements make for effective intervention and treatment. The SAAT program is based on a three phase approach, each phase having a specific treatment focus. Once treatment goals are establushed and agreed on, (based on the recommendations from the Assessment) the first phase of treatment begins.

Phase 1 –The focus is on providing psycho-educational information and teaching cognitive and affective coping strategies to both child/youth and parents/caregivers.

Phase 2 – Using various techniques, the unique impact of the trauma is addressed.

Phase 3 – The focus is on helping the child/youth and parents/caregivers move on and beyond the trauma experience.

Parental involvement in treatment is very important. It increases the effectiveness of treatment overall; it is actively encouraged in all cases and certainly when children under the age of 12 are involved.

Timing of treatment cannot be accurately determined in advance. However, our professional clinical staff remain mindful of the treatment goals and the sessions are intentionally focused on the accomplishment of desired goals and outcomes.

Quality Assurance

The Clinical Supervisor oversees all client involvement in the SAAT program, reviews and approves each assessment and provides clinical consultation to professional staff throughout the assessment and treatment phases. Written policies and procedures guide the operations of the program including code of professional conduct and specify standards of care. Evidence-based best practice informs program design and delivery.

Our Clinical Members, in addition to their professional qualifications, have specialized training and experience working with children, youth and families who have experienced trauma, and in particular, children and youth who have been sexually abused or have engaged in concerning sexualized behaviour.

Referral Process

If you are interested in making a referral to the SAAT program, please call Contact Hamilton at (905) 570-8888. Other sources include child welfare agencies, including Hamilton Children's Aid Scoiety and Hamilton Catholic Children's Aid Society.

Appointments

General office hours are Monday to Friday, 8:30a.m. to 4:30p.m. Our clinical team try to be flexible when arranging appointment times in an effort to accommodate our clients' needs